Colm Burke (Fine Gael)
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I understand the Minister is also taking the matter I have raised, which relates to the recruitment of junior doctors.

According to figures for 2011, there are 4,751 junior doctors employed in the Irish health system. Of these, 1,703 are senior house officers, 546 are interns, 1,568 are registrars and 934 are senior registrar specialists. We do not have a problem with senior registrar specialists, who are all on five year contracts. However, there is considerable uncertainty regarding the contracts of senior house officers and registrars.

I did my own study of attitudes of final year medical students in 2012 and concluded that only 34.5% of graduates would be working in Irish hospitals 12 months after graduating from Irish universities. Part of the reason for this is that junior doctors are offered contracts of six months or 12 months. In Australia, New Zealand or the United Kingdom, doctors' contracts can be for two or three years. The contracts may mean working in more than one hospital, but they give security of employment and the prospect of a planned programme of medical education.

How are we going to deal with this issue? When the Government came to power in March 2011, the Minister for Health found there was a huge shortage of junior doctors, and the HSE had to go to India and Pakistan to recruit doctors. All of the people brought in at that time were given two year contracts which will expire in July 2013. We now need a plan to commence on 1 January 2013.

Jimmy Deenihan (Kerry North-West Limerick, Fine Gael)
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The Minister for Health apologises for his non-availability this evening. He has assured me that he will listen to the debate and respond to Senator Burke's question.

Against the background of shortages of non-consultant hospital doctors, NCHDs, in many countries, a number of recruitment and retention initiatives have been undertaken by the HSE in the past two years and, as a result, all essential hospital services have been maintained. Given the central role that NCHDs play in the provision of hospital services, ensuring the necessary number and types of NCHDs are available to the service is a priority issue for the Minister for Health.

Since 2007 the HSE has increased the proportion of training posts from 40% of all NCHD posts to over 80%, all of whom are recruited by postgraduate training bodies for placement in hospitals and agencies. The remaining 19% of posts not categorised as training posts, comprise a combination of posts occupied by doctors with contracts of indefinite duration and doctors who rotate regularly between different posts, some of whom have recently left or are hoping to rejoin training schemes. Three quarters of these posts are in HSE hospitals and agencies with the balance in HSE funded agencies.

The standard six month duration of contract arises from the rotation of doctors between different posts as part of training schemes. In cases where the relevant postgraduate training body does not fill a post, a vacancy arises to be filled by the HSE or HSE funded agency on a non-training basis. The majority of such posts are at senior house officer, SHO, and registrar level and tend to be located in small to medium-sized hospitals and concentrated in six areas: emergency medicine, anaesthesia, general surgery, orthopaedic surgery, general medicine and paediatrics.

In 2010, the HSE acted to address the issue of six month terms of contract on the basis that the configuration, tenure and supports for such posts were inadequate to attract the number and calibre of NCHDs required to provide safe, high quality services to patients and clients of the public health service. In this context, the HSE prepared proposals that hospitals move from the standard NCHD job offer of a six month contract at a single hospital site to a standard two year contract of employment. This would involve an element of rotation, including a placement for six months in a large regional centre or complex tertiary service setting. Such posts would remain graded as SHO or registrar posts, and appointments would be made under NCHD Contract 2010. The HSE has proposed that all vacant SHO and registrar posts would be advertised on this revised basis to existing staff locally, to agency staff nationally and internationally, and on a broader international basis.

The proposals are among a range of issues to be discussed between health service management and the Irish Medical Organisation under the auspices of the Labour Relations Commission in the coming weeks. My colleague, the Minister for Health, has asked me to assure the Senator that the HSE is committed to ensuring all doctors are given contracts that support service delivery and offer opportunities to post holders to develop their skills and expertise.

Colm Burke (Fine Gael)
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I thank the Minister for that response. I welcome the change he outlined but I am not convinced that all of the posts will have two or three year contracts, and we should move towards that. Certainty and security are important. Administration could be cut by more than 50% if we had two year contracts. That is how we should be moving. I will continue to raise the matter with the Minister for Health. We must ensure we are ready to deal with the vacancies that will arise on 1 July 2013. I thank the Minister for Arts, Heritage and the Gaeltacht for taking the time to be with us in the Seanad today and to deal with the matters raised.

Jimmy Deenihan (Kerry North-West Limerick, Fine Gael)
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I will convey the Senator's concerns to the Minister for Health. The Senator may wish to outline those concerns in a letter to the Minister, or if he outlines them in a letter to me, I will see to it that they are passed on to the Minister.